What's So Scary About Automation?

Confronting Our Collective Fear of Automation...

There's no mistaking what time of year it is. Nearly every shop I enter is stocked with Halloween candies, costumes, and decorations and the highway is peppered with billboards advertising haunted houses. In my neighborhood, lawns are adorned with everything from happy, inflatable pumpkins to realistic-looking corpses rising from the ground. A $6.9 billion dollar consumer industry is built upon embracing our fears. This month, millions of people will actually seek outscary situations and tackle their fears, head on.

"What the heck does this have to do with healthcare IT," you ask? Admittedly, on the surface, not much. But all this scary stuff got me thinking about fear and how this powerful emotion often drives personal and business decisions. Of course, sometimes heeding our fears is a very good thing; it keeps us from wandering down dangerous paths. But often, our fears are rooted in a lack of understanding about what's "out there" and they may hold us back from realizing potential.

Our staff engages in conversations with a lot of healthcare industry stakeholders, including full-time practicing clinicians, CMOs/CMIOs, and health system CEOs, to name a few. Because we've built and continue to expand our Practice Automation Platform, Charlie, we end up addressing people's fears of automation, specifically in the context of clinical workflows. We get challenged, for example:

From doctors: I don't want technology to make care decisions for me. I want control of my patients' care. From nurses: I don't want everything automated because I'm afraid they won't need me anymore. From leadership: I just can't invest in anything that doesn't provide immediate impact on quality and the bottom line.

These are very real and understandable fears. Healthcare is one of the last industries to automate work. We cling, myself included, to a very romantic idea of highly personal relationships with our caretakers and the idea of ceding that to a computer seems scary. We wonder if automating healthcare can be truly safe. We don't want to lose our jobs. But, the reality--and perhaps the irony-- is that a thoughtfully designed automation platform will bring us closer together, will make us safer, and will keep us happier at work. Let me explain.

For doctors who don't want to lose control of patient care...

Do you have the time right now to evaluate every patient in your practice or do you find yourself having to prioritize efforts so you can address your most complex cases? Just this week I read two blogs on Kevin MD, written by physicians lamenting the lack of time they have to spend with patients. One focuses on the extra efforts he extends to compensate for time constraints, while the other blasts technology. Dr. Suneel Dhand writes, "It is a travesty what electronic medical records have done to our ancient and noble profession. The time that physicians (and nurses) are spending with them is unacceptable, and quite simply a national disgrace."

What if technology was working for you instead of against you? What if, because of automation, you could have more meaningful patient visits and less after-clinic busywork? Our platform enables that by automating below-license tasks to reduce your inbox volume and to bring all relevant patient data to the forefront in your EMR, so that you don't spend valuable minutes searching for all the data you need to make informed recommendations. These recommendations are there to make your job easier, but you can still customize care plans for your patients. Let automation be your workhorse, so you focus on working top-of-license.

It is also really important to note that our platform intelligence is created by clinical folks. Our 1000+ medication protocols, for example, are researched and documented from evidence-based guidelines. We have a Chief Pharmacy Officer, a Chief Medical Officer, and nurses on staff who make sure we're "stocking" Charlie's brain with the right information. When our clients "hire" Charlie to work for them, they take our evidence-based guidelines and then customize them based on internal consensus and their health system's needs. Our technology is helping you execute only what your organization approves. No rogue robots here. Nothing to be afraid of!

For nurses who worry about jobs:

It is true that automating tasks will free up nurse time. If we had too many nurses in healthcare, then it would be scary to think about being replaced. According to most nursing associations and organizations, a nursing shortage is looming. With an aging population, more people accessing health care, and more chronic diseases to manage, we need our existing nurse community and then some! A quick Google search will turn up plenty of articles on nursing shortages.

When our technology, Charlie, is implemented, that his work makes it possible to decrease the number of nurses dedicated to a particularly task, like refill requests. In one major Midwest system that uses Swoop for refills, they were able to go from 12 to 3 nurses processing refills. Did that system lay off those nurses? No way. They actually shifted their focus to working on another big quality initiative. And nurses, like physicians, want more quality time with patients and less busywork.

We've also heard from nurses that they appreciate that standardized protocols have helped them consistently execute on orders, especially when they work in a call center and cannot be expected to know the nuance of each physician's practice.

For leadership who need improved care at lower cost:

I can't imagine being a health system executive right now. They are under extraordinary pressure from just about every angle. Patient expectations are rising, physicians burnout is causing retention issues, and regulatory changes are coming fast and furiously, to name just a few challenges. On top of this, leaders have to pay attention to their bottom line while delivering better, faster care than ever before.

We don't purport to solve all these problems, but feel strongly that by designing more efficient workflows, implementing a robust delegation model, and centralizing clinical tasks, you will quickly realize efficiency and quality gains. But you can't do this with manual processes, you have to leverage smart technologies to make it work. Automating busywork, particularly with our Charlie platform, can help you:

Address some of the root causes of physician burnout Improve response time to patient requests More efficiently use your talented staff Optimize your EMR investment Easily find and address gaps in care across your entire patient population (not just chronic conditions), and more

Some Closing Thoughts...

Automation doesn't need to be scary if it's designed and implemented thoughtfully. In closing, I'd like to share something our CEO, Jonathan Baran told me a few weeks ago. While researching the history of automation (including barriers to acceptance), he came across some information on the history of the elevator. Many of us are not old enough to remember when elevators were manually operated, but they were. When it came time to automate elevators, people were highly skeptical and downright fearful. Eventually, through experience, people began trusting the elevator to get them safely from floor to floor. Today we don't think twice before stepping into an elevator and shooting up thirty floors in seconds. Imagine our world without this! NPR has a quick story on this if you're interested in this little bit of pop culture/history.

Automation is here. It's in planes, in cars, in every facet of our life. It will be in healthcare soon too. The question is, can the industry put aside it's fears and embrace automation so that it can become active participants in designing the future.